Better Together: Enabling Collaboration between Education and Health Services for Children with Dysphagia

Purpose: This presentation describes preliminary findings from Quality Improvement work being undertaken by a collaboration of school-based and NHS Speech and Language Therapists to enable better coordination of care between health and school-based paediatric dysphagia services.

Background: Increasing numbers of children are being diagnosed with difficulties with eating, drinking and swallowing (EDS, 1;2). Good nutrition and hydration are critical to accessing education and are part of the holistic care that should be provided by schools for children with EDS difficulties (1;2), with well-coordinated multidisciplinary working key to effective dysphagia care (3). Specialist schools may commission their own Speech and Language Therapy (SLT) services for dysphagia, but there is a risk of disconnect between health and education-based services, with children potentially falling through the gaps, a risk that is increased in the UK by lack of guidance for dysphagia services in special schools.

Aim: The study explores perspectives of service stakeholders on best practice and collaborative working between health and school services for dysphagia services in special schools.

Method: Focus groups are being conducted with key stakeholders in special school services for paediatric dysphagia, to gain perspectives on what constitutes a good quality dysphagia service in special schools. Participants include: parents; school-based and NHS Speech and Language Therapists; school leaders; and school staff who support pupils with EDS difficulties. Common themes are being identified through thematic analysis.

Results: Key themes include the importance of effective coordination between school-based SLT and local health services, inclusion and partnerships across the multidisciplinary team, clarity in information sharing processes, and consideration of care during school holidays, when school-based services are closed.

Implications: Data from this work will contribute to co-created local guidance for special school dysphagia services in Buckinghamshire, but themes are applicable at national and international levels.

References:
1. Dawson et al., (2024). Go Team Go! Interprofessional Practice for Pediatric Feeding in the Schools. LSHSS, 55: 394-408
2. D’Angelo, E.C., (2024). Clinical Feeding and Swallowing Evaluation for the School-Based Speech-Language Pathologist. LSHSS, 55: 409-422
3. Cowpe et al., (2014). What do parents of children with dysphagia think about their MDT? A qualitative study. BMJ Open 2014:4:e005934. Doi:10.1136/bmjopen-2014-005934